Platelet Count as a Prognostic Indicator in Burn Septicemia

Abstract

Evaluation of platelet count and its significance in early detection of post burn septicemia for commencement of timely vigorous treatment against it. Studies investigating the role of platelets and platelet count in burn patients are rare, rather old and mostly presenting case reports. Septicemia is the most important cause of mortality in burns. Burn patients can only be saved if septicemia is detected early which requires very sensitive prognostic indicator. Total 594 adult burn patients were studied, by observing them for septicemia and studying their subsequent platelet counts using visual method. In non-survivors (256) gradual decline in platelet count was observed and minimal platelet count was observed before death of the patient, while in survivors (338) gradual rise in platelet count was observed. No significant variation observed in other laboratory parameters such as total neutrophil count and serum creatinine. In significant number of non survivor (62.11%) platelet count was low before their death and in significant number of survivor (86.09%) platelet count was normal before their discharge. Thus it is conclude that serial declining platelet count is a very sensitive prognostic factor in early detection of post burn septicemia.

Platelet count: A predictor of sepsis and mortality in severe burns

“…Daily logistic regression models were conducted for the nadir (days 2-4) and peak (days [11][12][13][14][15][16][17] to investigate the relationship of platelet count on survival and sepsis. Analyses were conducted firstly with platelet count alone as a predictor, then with rBaux score added to the model to adjust for burn injury burden.…”

“…Intriguingly, platelet counts post-burn injury tend to follow a distinct pattern; falling to a nadir at day 2-5, then rising to a peak value at day 10-18. This has been investigated within animal models, case reports [7][8][9], and a number of larger scale studies [10][11][12]. A number of these studies have compared platelet counts and mortality [10,11,13]. More recently, Marck et al investigated platelet counts within a large heterogeneous group (N = 244) of adult and paediatric burns patients, where 80% of the cohort had burns covering less than 29% total body surface area (TBSA).…”

The Value of Neutrophil to Lymphocyte Ratio, Platelet Count and Red Cell Distribution Width to Platelet Ratio as Prognostic Markers in Burn Patients

“…Platelets play an important role in severe hemostatic disorder and in the disordered immune response in severe burn patients. There is release of a variety of inflammatory mediators that express pro-inflammatory response and interact with leukocytes and endothelial cells to induce acute and chronic immune response [17] . The main inflammatory cells responsible for promoting burn injury are neutrophils, mast cells, monocytes and macrophages whose activities are mediated by a number of cytokines and growth factors which directs the progression through the healing cascade [18] .…”

Early Initiation of Post-Pyloric Feeding in Patients with Major Burns: Experience in Taiwan Formosa Water Park Dust Explosion Disaster

“…Platelets play an essential role in severe haemostasis disorders and immune response impairments in burns patients. Monitoring the platelet count is important during the resuscitation and care of severely burned patients (Gajbhiye et al 2013). In critically ill patients, a blunted rise in platelet count has unfavourable prognosis (Nijsten et al 2000).…”